Abstract: Hypothyroidism, also called underactive thyroid disease. It is a common disorder. With hypothyroidism, thyroid gland does not make enough thyroid hormone. The thyroid gland is located in the front lower part of neck. Hormones released by the gland, travel through bloodstream and affect nearly every part of body, from heart and brain, to muscles and skin. The thyroid controls, our body’s cells to use energy from food, a process called metabolism. This metabolism affects body’stemperature, heartbeat, if we don’t have enough thyroid hormone, our body processes slow down. That means body makes less energy, and metabolism becomes sluggish.
In our system of medicine, we achieve “CURE” by HOLISTIC AND INDIVIDUALISTIC approach. According to Dr. Hahnemann § 2, The highest ideal of cure is a rapid, gentle and permanent restoration of health or removal and annihilation of the disease in its whole extent, in the shortest, most reliable and most harmless way, on easily comprehensible principles. That means Homoeopathy treat the root cause of disease
Keywords:Hypothyroidism, Individualization, constitutional remedy
Introduction:
Hypothyroidism reduced production of thyroid hormone is the central feature of the clinical state termed hypothyroidism. Primary hypothyroidism is due to disease of thyroid itself. It accounts for approximately 99% of cases, with < 1% being due to TSH deficiency known as central or secondary hypothyroidism. Primary hypothyroidism can be further subclassified depending on whether it is associated with goiter or an atrophic gland, and each of these entities can either be congenital or acquired in etiology.
Causes of hypothyroidism
Primary hypothyroidism with goiter
Acquired
Hashimoto’s thyroiditis
Iodine deficiency disorders
Goitrogen exposure
Antithyroid drug treatment
Congenital
Iodide transport or utilization defects in thyroid hormonogenesis
Primary hypothyroidism with atrophic gland
Acquired
Atrophic thyroiditis
Post-ablative hypothyroidism (radioiodine therapy, surgery)
Congenital
Thyroid agenesis
Thyroid dysplasia
Transient primary hypothyroidism
After thyroiditis: silent, subacute or post-partum thyroiditis
Central hypothyroidism
Acquired Pituitary or hypothalamic disease, e.g. tumor, hemorrhage, granulomatous disease, hypophysitis
Congenital TSH deficiency or TSH receptor defects
Resistance to thyroid hormone action
Generalized resistance to thyroid hormone action
Clinicalfeature:
• Thyroid: Enlargement of the gland
• Gastrointestinal: Decreased appetite, constipation, ileus, ascites
• Cardiorespiratory: Angina, bradycardia, hypertension, cardiac failure, pericardial effusion, pleural effusion
• Neuromuscular: Aches and pains, muscle stiffness, delayed relaxation of tendon reflexes (Woltman’s sign), carpal tunnel syndrome, deafness, depression, psychosis, cerebellar ataxia, myotonia
• Dermatological:Myxedema (non-pitting oedema of the skin of hands, feet and eyelids), dry flaky skin and hair, alopecia, vitiligo, purplish lips and malar flush, carotenaemia, xanthelasmas
• Reproductive: Menorrhagia, infertility, galactorrhea, impotence
• Hematological: Macrocytosis, anemia
• Miscellaneous: Tiredness, somnolence, cold intolerance, hoarseness of voice, low-pitched voice, slurred speech, weight gain
Diagnosis:
Plasma TSH is the best initial diagnostic test, and a normal value excludes primary hypothyroidism. Low T4 with elevated TSH confirms the diagnosis of primary hypothyroidism, while normal T4 with isolated elevation of TSH leads to the diagnosis of subclinical hypothyroidism. Individuals with subclinical hypothyroidism who have elevated anti-TPO antibodies are more likely to progress to overt hypothyroidism than antibody negative individuals. Central hypothyroidism is characterized by a low T4 and an inappropriately normal TSH. Evaluation for other pituitary hormone deficiency is recommended to confirm the diagnosis and guide therapy. Imaging to look for pituitary-hypothalamic disease using MRI should also be performed. In severe non-thyroidal illness also, total plasma T4 and T3 are low. These may revert to within normal range in 3 to 6 months after recovery from illness.
Case 1:
A 47 years old woman was 1st seen on 29 April 2023 for complaint of pitting oedema, weight 86 kgs, thigh pain, hair fall, itching at female Genito-urinary tract and cubital fossa region, body heaviness, lower back pain, where mom has diabetes hypertension, dad hypertension, her OBGY history G1P1A0L1 LSCS since breech position, hysterectomy done much bleeding in 2016 fibroid history having report (fig 1). Took conventional treatment for 7 yrs, was taking proper treatment Tb.Thyronorm 100 mcg, she also had her characteristics mental symptoms like attached much to son as husband was in abroad ,difficult to adjust, she thought her decision was wrong ,fear of continuing job due to seniors thought of resignation ,can’t tolerate rudeness, weeping in alone ,less confidence since childhood ,wants silent when irritated, needs company ,fear height ,water, have physical symptoms as desire for rice sour, pickles, fish,papad ,aversion mushroom, thirst less, sweat scanty ,normal bowel bladder activity, sleep is normal, she was given Natrum muriaticum 30 1 dose 4 Pills as first dose, as it covers totality and pathogenesis
Other differential remedies Pulsatilla, Ignatia,etc.
But after prescription of Natrum muriaticum 30 1 dose, the symptoms changed were weight 82.6 Kgs., swelling reduced,itching reduced, mild improvement in hair fall, no more heaviness in body felt and back pain reduced and report changes noticed as (fig 2) and now not on thyroid supplements.
Case 2: –
A 51 years old woman was 1st seen on 1 Feb 2023 for complaint of polyarthritis knee pain unable to fold knee joint crept present knee joint, wrist joint, hair fall, weight 64.6 Kgs, skin dryness, where mom has osteoarthritis, dad died old age, her OBGY history G1P1A0L1 FTND -full term normal delivery, conceived 8 yrs after marriage, menopause at her 45 yrs age, (fig 1). Took conventional treatment for 3 yrs, was taking proper treatment Tb. Thyronorm 75 mcg, she also had her characteristics mental symptoms like sensitive to rudeness, sensitive loud noise to, anger contradiction when, dictatorial, have physical symptoms as desire ns, aversion ns, thermal hot, thirst less, sweat on exertion, bowel constipated on and off, bladder normal sleep normal, she was given sepia 30 1 dose 4 pills as first dose, as it covers totality and pathogenesis Other differential remedies Arsenic album,Nux vomica
But after prescription of sepia 30 1 dose the symptoms changed were weight 60.1 kgs,reduced joint pain knee pain time of walk stand increased,no crept seen now, swelling reduced, hair fall reduced, skin dryness reduced,and report changed noticed as (fig 2) and now stopped taking thyroid supplements
Case 3:-
A 32 years old lady having weight 75 Kgs was 1st seen on 1st sept 2023 for complaint of body ache, knee pain, heel pain, constipation, weakness came before time of appointment (15 mins), mom lumbar spondylosis hypertension, Ca breast treated wholly, dad diabetes and psoriasis, her menstrual history is normal regular, OBGY history G1P0A1L0 ectopic pregnancy right tube thyroid detected 3 yrs ago this female is working women nurse sister by profession, having report (fig 1). Taking conventional treatment since 3 yrs was taking proper treatment Tb.Thyronorm 100 mcg she also had her characteristics mental symptoms like no good relation with sister in law as she use to taunt her all the time, father in law use to drink , desired to escape from this was feeling ,desire peace ,anger and irritability was been suppressed ,aversion to see sister in law, patient was elder in her in-laws house, where as youngest in her house , consolation ameliorate her, anxiety of parents health, have physical symptoms as desire for fish sour aversion sweets thirst 3 liter per day dreams fearful ghost of wake up by startled thermal hot sleep unrefreshing sweat on exertion she was given Carcinosin 200 1 dose as first dose, as it covers totality and pathogenesis
Other remedies indication Causticum,Phosphorus,Staphysagria
But after prescription of Carcinosin 200 1 dose the symptoms changed were weight 68 Kgs, swelling reduced,itching reduced, mild improvement in hair fall, no more heaviness and reports are seen after our treatment in fig(2), where patient is not on any thyroid supplements
*References/Bibliography: *
1) Munjal YP. API Textbook of Medicine. 9TH ed. Mumbai: Dr Yash Pal Munjal for and on behalf of The Association of Physicians of India; 2016.
2) K George Mathew & Pravin Agrawal Textbook of medicine. Sixth ed.
3)Boericke W Pocket manual of Homoeopathic Materia& repertory.11th edition,New Delhi: B. Jain Publisher (P) LTD;2012.
Co-Authors –
Dr.Aditi Malkani, BHMS, MD, Assistant Professor (Department of Homoeopathic Materia medica), P.P Savani Homeopathic medical college ,Dhamdod, Kosamba, Dist.Surat – 394125 -Gujarat
Dr.Prasad Kapadni, BHMS, Associate Professor, (Department of Practice of Medicine) Smt. KBAHMC Chandwad Dist. Nashik,423101 Maharashtra
Shriansh P Kapadni, 1st yr MBBS student, BVP RMC- Loni
